Challenges in the study of causation of obesity: Conference on ‘Multidisciplinary approaches to nutritional problems’ Symposium on ‘Diabetes and health’
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Use of the energy balance equation for understanding the causation of obesity is discussed. Its basis on the thermodynamic laws is expressed in mathematical models for body-weight changes. Only a very small net energy surplus per time unit constitutes the energy deposition during weight gain, making measurements of its components difficult. The physical laws provide exact quantitative relationships between energy intake, energy expenditure and deposition of energy, but cannot disentangle the initiating and driving forces of the energy imbalance, which may also be an active storage of fat in adipose tissue. These and various other limitations of the energy balance model warrant cautiousness in using the model in studies of obesity causation. Weight gain may be self-promoting and mathematical feedback models allowing estimation of such effects show that they are realistic. Predisposition and susceptibility should be distinguished, and susceptibility as a modifiable predisposition, the genetic and environmental contribution to predisposition and its usefulness as targets for prevention and treatment are discussed. Current progress in unravelling genetic predisposition, the complex genetically-determined mechanisms, the slower progress in unravelling the environmental influences, the different nature of genetic and environmental influences, the possible pathways of environmental influences and the environmental influences as mediators of genetic effects are addressed. The evidence behind the prevailing concept of the ‘obesogenic’ environment is critically analysed. Finally, particular opportunities for the identification of the causes of the obesity epidemic by detailed analysis of an observed irregular development of the epidemic over long time periods are presented, and evidence for predisposition as a result of postnatal environmental influences is inferred from these studies.
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A similar vicious circle is seen for other weight-promoting behaviors, notably physical inactivity and overeating, both of which are reinforced by weight gain.
“Such phenomenon is observed for other weight promoting behaviors, notably physical inactivity and overeating, both of which are reinforced by weight gain [158].”
From Sleep and metabolic function (2012) · cites this paper as [158]
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Cites
Obesity : Preventing and managing the global epidemic
Akram, D. S., Astrup, A. V., Atinmo, T., Boissin, J.-L., Bray, G. A., Carroll, K. N., Chitson, P., Chen, C., Dietz, W. H., Hill, J. O., et al. (2000) · Research at the University of Copenhagen (University of Copenhagen) · Cited by 12,945 · see citing works
Frayling, T. M., Timpson, N. J., Weedon, M. N., Zeggini, E., Freathy, R. M., Lindgren, C. M., Perry, J. R. B., Elliott, K. S., Lango, H., Rayner, N. W., et al. (2007) · Science · doi:10.1126/science.1141634 · Cited by 4,531 · see citing works
Effect of In Utero and Early-Life Conditions on Adult Health and Disease
Gluckman, P. D., Hanson, M. A., Cooper, C., & Thornburg, K. L. (2008) · New England Journal of Medicine · doi:10.1056/nejmra0708473 · Cited by 3,898 · see citing works
Mattick, J. S., & Makunin, I. V. (2006) · Human Molecular Genetics · doi:10.1093/hmg/ddl046 · Cited by 2,471 · see citing works
Obesity and the regulation of energy balance
Spiegelman, B. M., & Flier, J. S. (2001) · Cell · doi:10.1016/s0092-8674(01)00240-9 · Cited by 2,398 · see citing works
Obesity and the Environment: Where Do We Go from Here?
Hill, J. O., Wyatt, H. R., Reed, G. W., & Peters, J. C. (2003) · Science · doi:10.1126/science.1079857 · Cited by 2,180 · see citing works
Franz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., Bowman, J. D., & Pronk, N. P. (2007) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2007.07.017 · Cited by 1,559 · see citing works
The Obesity-Associated FTO Gene Encodes a 2-Oxoglutarate-Dependent Nucleic Acid Demethylase
Gerken, T., Girard, C. A. J., Tung, Y. L., Webby, C. J., Saudek, V., Hewitson, K. S., Yeo, G. S. H., McDonough, M. A., Cunliffe, S. L., McNeill, L. A., et al. (2007) · Science · doi:10.1126/science.1151710 · Cited by 1,519 · see citing works
Common variants near MC4R are associated with fat mass, weight and risk of obesity
The Prostate, L., Loos, R. J. F., KORA, Study, N. H., Initiative, D. G., Study, T. S., The Wellcome Trust Case Control Consortium, FUSION, Lindgren, C. M., Li, S., et al. (2008) · Nature Genetics · doi:10.1038/ng.140 · Cited by 1,325 · see citing works
Reduced Rate of Energy Expenditure as a Risk Factor for Body-Weight Gain
Ravussin, E., Lillioja, S., Knowler, W. C., Christin, L., Freymond, D., Abbott, W. G. H., Boyce, V., Howard, B. V., & Bogardus, C. (1988) · New England Journal of Medicine · doi:10.1056/nejm198802253180802 · Cited by 1,215 · see citing works
Obesity in Britain: gluttony or sloth?
Prentice, A. M., & Jebb, S. A. (1995) · BMJ · doi:10.1136/bmj.311.7002.437 · Cited by 1,163 · see citing works
Hattersley, A. T., & Tooke, J. E. (1999) · The Lancet · doi:10.1016/s0140-6736(98)07546-1 · Cited by 909 · see citing works
An “ecological” approach to the obesity pandemic
Egger, G. J., & Swinburn, B. (1997) · BMJ · doi:10.1136/bmj.315.7106.477 · Cited by 864 · see citing works
Putative contributors to the secular increase in obesity: exploring the roads less traveled
Keith, S. W., Redden, D. T., Katzmarzyk, P. T., Boggiano, M. M., Hanlon, E. C., Benca, R. M., Ruden, D. M., Pietrobelli, A., Barger, J. L., Fontaine, K. R., et al. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803326 · Cited by 633 · see citing works
Copy-number variation and association studies of human disease
McCarroll, S. A., & Altshuler, D. M. (2007) · Nature Genetics · doi:10.1038/ng2080 · Cited by 622 · see citing works
Does physical activity prevent weight gain – a systematic review
Fogelholm, M., & Kukkonen‐Harjula, K. (2000) · Obesity Reviews · doi:10.1046/j.1467-789x.2000.00016.x · Cited by 598 · see citing works
Obesity Associated Genetic Variation inFTOIs Associated with Diminished Satiety
Wardle, J., Carnell, S., Haworth, C. M. A., Farooqi, I. S., O’Rahilly, S., & Plomin, R. J. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0472 · Cited by 526 · see citing works
Dietary fat and obesity: evidence from epidemiology.
Lissner, L., & Heitmann, B. L. (1995) · PubMed · Cited by 429 · see citing works
Physical activity and obesity prevention: a review of the current evidence
Wareham, N. J., van Sluijs, E. M. F., & Ekelund, U. (2005) · Proceedings of The Nutrition Society · doi:10.1079/pns2005423 · Cited by 413 · see citing works
Appetite and adiposity in children: evidence for a behavioral susceptibility theory of obesity
Carnell, S., & Wardle, J. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.1.22 · Cited by 406 · see citing works
Metabolic Responses to Reduced Daily Steps in Healthy Nonexercising Men
(2008) · JAMA · doi:10.1001/jama.299.11.1259 · Cited by 313 · see citing works
Westerterp, K. R., & Speakman, J. R. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.74 · Cited by 269 · see citing works
Longitudinal study of the long-term relation between physical activity and obesity in adults
Petersen, L. V., Schnohr, P., & Sørensen, T. I. A. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802548 · Cited by 256 · see citing works
Self-citationPatterns of weight change and their relation to diet in a cohort of healthy women
Colditz, G. A., Willett, W. C., Stampfer, M. J., London, S. J., Segal, M. R., & Speizer, F. E. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/51.6.1100 · Cited by 254 · see citing works
Sørensen, H. T., Sabroe, S., Rothman, K. J., Gillman, M. W., Fischer, P., & Sørensen, T. I. A. (1997) · BMJ · doi:10.1136/bmj.315.7116.1137 · Cited by 249 · see citing works
Self-citationO'Rahilly, S., & Farooqi, I. S. (2008) · Diabetes · doi:10.2337/db08-0210 · Cited by 205 · see citing works
Prentice, A., Black, A., Coward, W. A., & Cole, T. J. (1996) · PubMed · Cited by 187 · see citing works
The fundamental drivers of the obesity epidemic
James, W. P. T. (2008) · Obesity Reviews · doi:10.1111/j.1467-789x.2007.00432.x · Cited by 179 · see citing works
The Importance of Energy Balance
Hill, J. O., Wyatt, H. R., & Peters, J. C. (2010) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2013.09.02.111 · Cited by 141 · see citing works
Rugholm, S., Baker, J. L., Olsen, L. W., Schack‐Nielsen, L., Bua, J., & Sørensen, T. I. A. (2005) · Obesity Research · doi:10.1038/oby.2005.271 · Cited by 129 · see citing works
Self-citationKroke, A., Liese, A., Schulz, M., Bergmann, M. M., Klipstein‐Grobusch, K., Hoffmann, K., & Boeing, H. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0801920 · Cited by 125 · see citing works
Sørensen, T. I. A., & Sonne‐Holm, S. (1988) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114770 · Cited by 89 · see citing works
Self-citationObesogenic environments – aspects on measurement and indicators
Elinder, L. S., & Jansson, M. (2008) · Public Health Nutrition · doi:10.1017/s1368980008002450 · Cited by 85 · see citing works
Prospective Associations between Sedentary Lifestyle and BMI in Midlife
Mortensen, L. H., Siegler, I. C., Barefoot, J. C., Grønbæk, M., & Sørensen, T. I. A. (2006) · Obesity · doi:10.1038/oby.2006.166 · Cited by 81 · see citing works
Self-citationSecular Trends in Childhood Obesity in Denmark During 50 Years in Relation to Economic Growth
Bua, J., Olsen, L. W., & Sørensen, T. I. A. (2007) · Obesity · doi:10.1038/oby.2007.603 · Cited by 79 · see citing works
Self-citationThomsen, B., Ekstrøm, C. T., & Sørensen, T. (1999) · International Journal of Obesity · doi:10.1038/sj.ijo.0800907 · Cited by 77 · see citing works
Self-citationSecular Change in Size at Birth from 1973 to 2003: National Data from Denmark
Schack‐Nielsen, L., Mølgaard, C., Sørensen, T. I. A., et al. (2006) · Obesity · doi:10.1038/oby.2006.143 · Cited by 76 · see citing works
Self-citationOverfeeding in identical twins: 5-year postoverfeeding results
Bouchard, C., Tremblay, A., Després, J., Nadeau, A., Lupien, P. J., Moorjan, S., Thériault, G., & Kim, S. Y. (1996) · Metabolism · doi:10.1016/s0026-0495(96)90277-2 · Cited by 73 · see citing works
Bak, H. K., Petersen, L. V., & Sørensen, T. I. A. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802525 · Cited by 72 · see citing works
Self-citationBirth Cohort Effect on the Obesity Epidemic in Denmark
Olsen, L. W., Baker, J. L., Holst, C., & rensen, T. I. A. S. O. (2006) · Epidemiology · doi:10.1097/01.ede.0000208349.16893.e0 · Cited by 70 · see citing works
Quantitative analysis of the energy requirements for development of obesity
Christiansen, E., Garby, L., & Sørensen, T. I. A. (2005) · Journal of Theoretical Biology · doi:10.1016/j.jtbi.2004.11.012 · Cited by 68 · see citing works
Self-citationPost-War course of the prevalence of extreme overweight among Danish young men
Sonne‐Holm, S., & Sørensen, T. I. A. (1977) · Journal of Chronic Diseases · doi:10.1016/0021-9681(77)90029-7 · Cited by 66 · see citing works
Self-citationComposition (lean and fat tissue) of weight changes in adult Danes
Heitmann, B. L., & Garby, L. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/75.5.840 · Cited by 65 · see citing works
Genes and type 2 diabetes mellitus
Groop, L., & Lyssenko, V. (2008) · Current Diabetes Reports · doi:10.1007/s11892-008-0033-y · Cited by 60 · see citing works
Olds, T., & Harten, N. (2001) · Human Biology · doi:10.1353/hub.2001.0071 · Cited by 54 · see citing works
Secular trends in body mass index among Danish young men.
Sørensen, T. I., & Price, R. A. (1990) · PubMed · Cited by 53 · see citing works
Self-citationRecovery of initial body weight and composition after long-term massive overfeeding in men
Pasquet, P., & Apfelbaum, M. (1994) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/60.6.861 · Cited by 50 · see citing works
Short Communication - Continued increase in prevalence of obesity in Danish young men
Ht, S., Sabroe, S., Gillman, M. W., et al. (1997) · International Journal of Obesity · doi:10.1038/sj.ijo.0800461 · Cited by 48 · see citing works
Price, R. A., Ness, R. B., & Sørensen, T. I. A. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115917 · Cited by 36 · see citing works
Self-citationCapel, F. (2007) · CRC Press eBooks · doi:10.3109/9781420020137 · Cited by 31 · see citing works
Constant median body mass index of Danish young men, 1943-1977.
Christensen, U., Sonne‐Holm, S., & Sørensen, T. I. A. (1981) · PubMed · Cited by 30 · see citing works
Self-citationFeedback models allowing estimation of thresholds for self-promoting body weight gain
Christiansen, E., Swann, A., & Sørensen, T. I. A. (2008) · Journal of Theoretical Biology · doi:10.1016/j.jtbi.2008.07.004 · Cited by 16 · see citing works
Self-citationObesity in the Scandinavian Countries: Prevalence and Developmental Trends
Sørensen, T. I. A. (1987) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1987.tb05923.x · Cited by 14 · see citing works
Self-citation
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Research works printed but not linked: 3
- Schack-Nielsen L (2008) Early life obesity risk factors: An epidemiological study of maternal gestational weight gain, birth weight, breastfeeding and complementary feeding in relation to obesity. PhD Thesis, University of Copenhagen, Denmark.
- Worre-Jensen AL, Heitmann BL, Kyvik KO et al. (2008) Genetic influence on dietary intake in twin studies. J Nutr (In the Press).
- Giskes K, Kamphuis CB, van Lenthe FJ et al. (2007) A systematic review of associations between environmental factors, energy and fat intakes among adults: is there evi- dence for environments that encourage obesogenic dietary intakes? Public Health Nutr 10, 1005-1017.
Cited by
Sorted by citations
Rokholm, B., Baker, J. L., & Sørensen, T. I. A. (2010) · Obesity Reviews · doi:10.1111/j.1467-789x.2010.00810.x · Cited by 601 · see citing works
Self-citationThe pathophysiology of hypertension in patients with obesity
DeMarco, V. G., Aroor, A. R., & Sowers, J. R. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.44 · Cited by 545 · see citing works
Nielsen, L. S., Danielsen, K. V., & Sørensen, T. I. A. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2010.00724.x · Cited by 338 · see citing works
Self-citationMorselli, L. L., Guyon, A., & Spiegel, K. (2012) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-011-1053-z · Cited by 199 · see citing works
“Such phenomenon is observed for other weight promoting behaviors, notably physical inactivity and overeating, both of which are reinforced by weight gain [158].”
King, N. A., Horner, K., Hills, A. P., Byrne, N. M., Wood, R. E., Bryant, E., Caudwell, P., Finlayson, G., Gibbons, C., Hopkins, M., et al. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsm.2010.082495 · Cited by 169 · see citing works
Brain control of energy homeostasis: implications for anti-obesity pharmacotherapy
Johansen, V. B. I., Petersen, J., Lund, J., Mathiesen, C. V., Fenselau, H., & Clemmensen, C. (2025) · Cell · doi:10.1016/j.cell.2025.06.010 · Cited by 53 · see citing works
- Authors
- Sørensen, T. I. A.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Sørensen, Thorkild I. A.
- Venue
- Proceedings of the Nutrition Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-12-15
- Volume
- 68
- Issue
- 1
- Pages
- 43-54
- ISSN
- 0029-6651 (ISSN-L)
- 1475-2719
- OpenAlex
- W2103742347
- Cited by
- 75
- References
- 53
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 7 · 2014: 8 · 2013: 7 · 2012: 5
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of The Nutrition Society (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Strategiske Forskningsråd (2101-06-0005)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- energy balance model, energy intake, energy expenditure, energy deposition, feedback model, genetic susceptibility, environmental influences, obesogenic environment, gene-environment interaction, obesity prevention, obesity epidemic
- MeSH terms
- Adipose Tissue, Adolescent, Basal Metabolism, Energy Intake, Child, Diabetes Mellitus, Diet, Eating, Energy Metabolism, Environment, Female, Homeostasis, Humans, Infant, Low Birth Weight, Infant, Newborn, Male, Models, Theoretical, Obesity, Thermodynamics, Time Factors, Weight Gain, Exercise, Genetic Predisposition to Disease, Young Adult
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